Mountain Bay Dental LLC
NPI 1295268019ActiveOrganization· Dentist, General Practice· Champaign, IL
Dentist, General Practice in Champaign, Illinois, registered in NPPES in April 2017. The authorized official on file is Lanae W. Johnson, Manager.
Overview
| NPI | 1295268019 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 8, 2017 |
| Last updated in NPPES | Apr 8, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 1001483 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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